I have had tongue fasciculations (twitches, myokymia?) for the past 3 months. I can feel them. They last just a few seconds and then go away. I have them maybe once a week.

I had a clean emg of my tongue 3 weeks ago. I'm 24 years old.

Am I in the clear?

1. I've read EMG's are only 60% sensitive for MND's. Is this true?2. I've read tongue fasciculations are never benign. Is this true?3. Are ALS related fasciculations constant from the start, or could the come and go like this?

Good questions for a Neurologist. Accuracy depends on experience, technique and number of areas tested. Absolutes like "Never" are unlikely and rare to be true. As far as I know, once in effect with ALS, they are continuous until muscle death. That said re-innervation or benign twitching can be constant. Hope this helps.

1. Have no idea really about exact figures, but as far as I can see form stories told on this board, they find pathological changes even when they are not manifested clinically yet.2. Tongue TWITCHES are usually benign but plain people often confuse them for fasculations. Only a neuro can distinguish them, so self-diagnosis is clueless.3. As far as I know, ALS fascics are continous until complete death of the muscle and are rather faint and need stroboscope to see them. What we usually have are twitches, and this is different process.

TONGUE- If you’ve developed the habit of persistently examining your tongue in a mirror, you are wasting valuable time if your only symptom is twitching. You may be perceiving difficulties chewing and swallowing food, but there is a huge difference between perception and performance. If the food is getting chewed in a reasonable amount of time, and swallowed without gagging and choking, then you do not have bulbar onset ALS.

Yuliasir wrote:1. Have no idea really about exact figures, but as far as I can see form stories told on this board, they find pathological changes even when they are not manifested clinically yet.2. Tongue TWITCHES are usually benign but plain people often confuse them for fasculations. Only a neuro can distinguish them, so self-diagnosis is clueless.3. As far as I know, ALS fascics are continous until complete death of the muscle and are rather faint and need stroboscope to see them. What we usually have are twitches, and this is different process.

What's the difference between twitches and fasciculations? Usually the tip of my tongue twitches for a few times and then it goes away.

as for the difference between twitching and fasciculations, as far as I know, there is a difference on the EMG level - special features, like specific rate/amplitude or waveform. Benign twitching seems to be less organized or have another specific features, allowing to make a differential diagnosis.At least when I had my emg, the doctor was very curious about certain rhytmic activity found in my thumb muscle (despite on having irregular twitching contractions) - he really tortured me with the needle to get more samples of this waves and analysed them using statiscitcs to determine if they are indicative of motor neuron damage or not (finally he decided that this was not a pathological sign).

Xina535 wrote:What is the hyperexcitability phase and when does it occur? Does it always occur?

It does not always occur. It's a phase where nothing but fasciculations show on EMG. It's rare forit to last longer than a few weeks. It's been studied only in pals, never as a first symptom. So please don't worry just because I do. I have OCD and always focus on the rarest cases.